From the award-winning New York magazine reporter and coauthor of the New York Timesbestseller Notorious RBG, an ambitious and passionate exploration of what’s gone wrong with pregnancy in America, through the lens of history, politics, and the searing experiences of five women.
Journalist Irin Carmon was eight months pregnant when the Supreme Court allowed states to ban abortion, unleashing pain and suffering for those who didn’t want to be pregnant and, shockingly to some, those who did. What was clear to Carmon from her dozen years of reporting—and from what she felt in her bones—was how incomplete the American story of reproduction had been, and how much had been unexpressed, hidden, or taken for granted, and not just by conservative justices or in red states. Whether in cosmopolitan, liberal New York City or rural Alabama, the entire system is broken.
Unbearable tells a deeper story, going beyond the headlines and any one experience or choice, and grounded in history and journalism. It introduces us to five women navigating pregnancy care—from that first positive pregnancy test through joy, loss, and the unforeseen—in a country that is at best indifferent and at worst willfully cruel, and to brave, outnumbered people fighting to make it better. Written with deep empathy and analytical rigor, Unbearable is at once a moving story of interconnection, a harrowing exposé, and assertion of humanity. Above all, it is a powerful call for solidarity, regardless of our circumstances or our decisions.
Irin Carmon is an Israeli-American journalist and commentator. She is a national reporter at MSNBC, covering women, politics, and culture for the website and on air. She is a Visiting Fellow in the Program for the Study of Reproductive Justice at Yale Law School.
In 2011, she was named one of Forbes' "30 under 30" in media and featured in New York Magazine as a face of young feminism. She received the November 2011 Sidney award from The Sidney Hillman Foundation recognizing her reporting on the Mississippi Personhood Initiative for Salon. Mediaite named her among four in its award for Best TV pundit of 2014.
I was raised in a very conservative household, and we never spoke about politics. I didn’t start to become “woke” until fall 2016, for pretty obvious reasons. It was then that I started to look more closely at the black and white beliefs I held. It was then that I started to realize that something in one of our major political parties was rotting and had been for quite some time. This book helped me to see, even more clearly, how pregnant women are treated in the United States. And it’s even worse than I had imagined. All women are affected, but the color of your skin comes into play in a big, big way.
You will be horrified.
You will cry.
You will rage.
Want to rage some more? Go look up J. Marion Sims. No, like, *really* go in-depth on his professional life. You may find a statue in Alabama that needs some…adjustments made to it.
Also, if you know a midwife and have held some negative opinions of them in the past? Go and beg her forgiveness. I know one I need to apologize to.
This book is EXTREMELY important to read, especially since Roe v. Wade was overturned, but it’s even more important, given that women in the U.S are seeing their reproductive rights being stripped away in real time. How long do you think it will be until contraception is banned? Think I’m being alarmist? Go look up Project 2025, which is close to 50% completed as of this writing (10/27/25).
They’ll try it.
The only question is, will we let them?
Thank you to NetGalley and Atria/One Signal Publishers for an eARC in exchange for my honest feedback. Thank you also to the author, who spent years of her time to make sure that this book saw the light of day.
"There is no way to recognize embryos or fetuses as separate persons without subtracting women from the community of constitutional persons."
Irin Carmon's "Unbearable" is a fascinating deep dive into what it means to be pregnant in America. The CDC in 2023 reported that 1 in 5 women reported mistreatment during birth . Carmon focuses on stories from five women located in New York and Alabama, two locations with starkly different laws and perspectives on women's rights during childbearing years. The stories span wide-ranging topics, from trying to get pregnant to trying to give birth safely, to a doctor trying to open new doors for women in need, and even a story of incarceration following birth.
Carmon elucidates how difficult it is to disentangle the concept of "fetal outcomes" from "maternal outcomes" and how black-and-white laws against abortion and "chemical endangerment" (which can include failing a drug or alcohol screener even before knowing you're pregnant) create an arbitrary line in the sand.
The book also includes a fascinating overview of the history of midwifery and how drastically birth outcomes took a turn when doctors took the reins, even when the situation didn't call for it. The background of how Sims changed the face of OBGYN care today through the abuse of slaves is honestly startling and not something I was aware of at all.
Regardless of whether one prefers a midwife or an OB, Carmon discusses the topic of maternity care deserts in rural areas, which contribute to limited resources and inadequate care for people in need. This topic is extremely timely, because even though Carmon describes it as primarily a rural area problem, since the new laws for maternal care have passed, more regions than ever have been slowly turning into maternity care deserts as medical professionals switch fields due to not being allowed to practice as they see fit.
The information is well-researched, and the women's stories are shocking and eye-opening. Thank you, NetGalley and Atria Books, for the opportunity to read an advanced reader's copy in exchange for my honest opinion.
"Privilege could insulate you from a lot, but pregnancy has a way of humbling everyone."
The topic of pregnancy and female medical care is one I find deeply personal and also interesting so I was excited to read the advanced copy of this book.
It took me a while to get through because I had to take breaks when the content got to be too heavy for me. It is hard to read about injustice and this book has many examples of how unfair our health care system is in America. I really liked the intersection of facts and stories of real women in this book. It was compelling and presented in an easy to digest way. I appreciate all the research that went into this book. I found the portions on the history of midwifery particularly interesting.
This book is powerful. Reading about the five different women with every different stories was very impactful and this is not a book I will forget anytime soon.
Thank you to NetGalley and the publisher for the arc.
Unbearable by Irin Carmon is a shocking book. I kept reading about what the pregnant women followed in her reporting endured at the hands of our healthcare and justice systems, thinking surely Carmon must be mistaken. Surely this couldn’t be happening in America?
Carmon is clear in stating that not all pregnant women experience the tragic health outcomes or nonsensical incarcerations shared in this book. She simply forces us to reckon with the fact that far too many women do. The counter narrative she offers of patient-centered care proves that another experience is available for those pregnant women lucky enough to access it. What is so heartbreaking is that even women who knew those options existed often failed to access them despite their best efforts. I hope Carmon’s book empowers all pregnant women and those who love them to advocate for themselves as though their lives depend on it.
Irin Carmon’s *Unbearable: Five Women and the Perils of Pregnancy in America* is a powerful, meticulously reported examination of the American pregnancy experience through the lives of five very different women. Combining history, policy analysis, and deeply personal narratives, Carmon explores the gaps and failures of a system that too often offers inadequate care, stigma, and trauma—regardless of political stance or geography. What begins as a patient’s journey blossoms into a broader critique of institutional neglect—from obstetric deserts to restrictive laws—imbued with empathy and urgency. Unflinching yet compassionate, *Unbearable* shines a light on what’s at stake for those who become pregnant in a country that claims autonomy but often withholds essential support. compelling call for systemic change, solidarity, and a renewed commitment to the humanity of pregnancy.
Very interesting and well-researched book. I enjoyed following the perspective’s of five different women whose reactions to their pregnancies and what happened was so different. However, as someone from Alabama, this book turned into the ultimate of depressing, scary, and infuriating reads. I’d buy a copy for every member of the legislature and Governor Ivey, but they’ve already demonstrated their lack of an open mind. As much as I hate it, I’d read this before risking pregnancy here!
I won this book through a Goodreads giveaway in exchange for an honest review. Thanks to Atria Books for choosing me.
This book was written with grace, empathy and respect. It was extremely eye-opening and one that I will be thinking about for years to come. I personally think everyone should read this book, because no matter who you are you will take something away from it.
I read this twice in two weeks. As soon as I finished the audiobook version, I knew I had to get my hands on a physical copy. The second reading demanded that I underline sentences, paragraphs, and sometimes nearly full pages. Carmon combines the intimate personal narratives of five women navigating pregnancy in modern, post-Roe America with research into the history of obstetrics and the legislation and criminalization of pregnant (and, ugh, pre-pregnant) bodies. This book exposes how the political and personal can intersect to devastating effect when it comes to fertility, abortion, and pregnancy. Maggie, Hali, Christine, Alison, and Yoshica's lived experiences serve to illuminate specific ways the legal and medical systems can and do fail individuals across the country, from rural Alabama to New York City. As I read and reflected on the suffering and resiliency found in these pages, and on the need for more compassionate, patient-centered care, I was reminded of another book I read and loved that inspired rage and awe: The Story of Jane: The Legendary Underground Feminist Abortion Service. I highly recommend both.
Infuriating, heartbreaking, shocking but somehow not surprising. I have many words to describe the stories detailed in this book and somehow none can fully encapsulate just how raw it was. I am not someone who is pregnant or planning to be, but as a white woman in the United States I had a limited view of just how dangerous pregnancy has been and could be for people in this country, particularly people of color. Go in cautiously as the book will obviously contain very triggering and traumatizing themes, but I would highly encourage you to pick this one up.
Thank you so so much to Atria for mailing me a review copy.
The award winning author of “Notorious RBG,” takes a deep dive into the fallout from the end of Roe v. Wade. Carmon reflects on how about half of the states immediately imposed abortion bans that have caused “unimaginable pain.” She addresses how reproduction is controlled through systemic misogyny, paternalism, and racism using tools that range from coercion to criminalization. She laments how some prioritize potential life over existing life, and the “crass reality” that money “can buy you a way out.” She points out how states are mandating that women continue pregnancies, yet fail to provide them with skilled providers, a safe environment, and the dignity and autonomy to which they are entitled.
To illustrate her points, Carmon focuses on five disparate women: (1) Maggie Boyd, a Canadian residing in New York with her husband who, after a surprise pregnancy, is disoriented by the American health system, including private insurance, deductibles, and co-pays. Boyd was disappointed by the lack of care that she received at a birth center, resulting in an emergency transfer to a hospital. During a C-section, a uterine artery was torn resulting in organ failure, the need for a full-body blood transplant, and the destruction of a part of Boyd’s pituitary gland; (2) Hali Burns, a married woman in Alabama who had managed her opioid addiction through prescribed Subutex, but tested positive for drugs during an unexpected second pregnancy, and was charged under the chemical endangerment laws leading to a prison sentence and preventing her from bonding with her baby and losing custody of her children; (3) Christine Fields, a New Yorker whose story poignantly Illustrates how Black women are at particular risk of poor reproductive medical care; (4) Allison Mollman, a married lawyer who lives in Alabama and works for the ACLU. She and her wife felt unwelcome at the fertility clinics they visited, and effective fertility treatment was difficult for them to procure because they flouted the conservative ideal of early heterosexual marriage and childbearing so the couple created a piecemeal insemination kit. Alison suffered several miscarriages, and the state refused to treat her as a patient because she was pregnant. Physicians sent her home without medication to speed along the miscarriages or D&Cs to remove the tissues although the pregnancies could not result in live births; and (5) Yashica Robinson, a physician in Alabama who excelled despite having two children when she was still in high school. Her illiterate grandmother helped her raise her children so that she could complete high school, and she received a full scholarship to an HBC and then was accepted to medical school at Morehouse. Yashica provided abortion services to her patients in Alabama, considering abortions a part of obstetrics. In her practice, she serves many Black women on Medicaid and offers them care that exceeds their expectations. She sued the state for preventing her from opening a birth center that would allow low risk patients to give birth on their own terms with safe, compassionate, and connected care provided by midwives freeing Yashica to tend to high risk pregnancies.
While focusing on these five women, Carmon investigates the enraging nature of the history of women’s reproductive care which has been dominated by white-coat patriarchs. White male doctors experimented on enslaved women, without surgical anesthesia (although it was then available), because Black procreation helped to sustain slavery. That research ultimately benefited white women’s reproductive health. White male doctors in the 19th century sought to supplant midwives and put them out of business by declaring abortions not only unsafe, but murderous. New state laws made abortion illegal at any stage of pregnancy, and left the control over pregnancy with white male doctors. Those nineteenth century abortion bans were not swept away until 1973 with Roe v. Wade, and then were ameliorated by Dobbs. Thank you Zakiya Jamal, Senior Marketing Manager, Atria Books, for an advance copy of this important book.
There is a lot worth reading in this book. If you're the kind of person who takes an interest in a book like this you're probably not going to have your mind blown by the knowledge that Dobbs has made doctors in red states afraid to provide even life-saving care in cases like ectopic pregnancies and placental abruptions, or that criminalizing drug use during pregnancy makes women into not-quite-rights-bearing citizens while also inflicting horrible danger on fetuses and newborns, but it's worthwhile to reencounter that knowledge in the context of specific, closely reported, absolutely infuriating individual stories.
I have some reservations, or maybe just confusion, about the discussion of midwifery vs. medically attended birth in this book. I didn't come into the book with any knowledge about this (I am a non-child-haver) and I felt like I could have used a clearer orientation on just what midwives are. Like, what kind of training do you need to be a midwife? In countries where midwives handle a large percentage of births, how do they usually interact with OBGYNs, and how do they deal with complicated births? Carmon attributes a lot of the problems with medical birth--unnecessary C-sections and episiotomies, nonconsensual administration of painkillers, disrespectful and objectifying treatment of women in labor--to the financial pressures on hospitals to get through births quickly and particularly to avoid spending extensive resources on women on Medicaid, for whom the reimbursement to the hospital will be limited. This seems perfectly convincing to me, but then what are midwife clinics doing differently to avoid those pressures? Everyone has bills, right? Carmon does cite statistics and studies, but they seem scattered--like, a fact from Vienna in the 1840s, then a fact from Alabama in the 1930s, then a fact from present-day New York. Quite late in the book there's a reference to a midwife-model clinic not offering epidurals, and this is treated as something that should be obvious. Maybe there's something I'm missing here, but it strikes me as really odd to not have epidurals available even as a backup plan, and I want to know what that's about! I don't know, maybe I was just supposed to come into this book with more knowledge than I did. (I will also note, this isn't a central point in the book at all, but there are some fairly positive references to the midwife Ina May Gaskin. Gaskin is an incredibly disturbing character who self-reports sexually abusing her patients and led a cult. So ... that doesn't leave me with a huge amount of confidence that midwifery is being presented in a fair light!)
Of note: I did not realize the author was Israeli until after having read this, and according to Wikipedia she is the granddaughter of Zionists. I tried to see if she, herself, holds these beliefs, and I could not find anything from her regarding her views. That being said, her silence says volumes.
This book is, honestly, absolutely horrifying, and it will be a hard read. I first was under the impression that it would follow women from different parts of the country, but I quickly realized that was not the case. There is a woman in Alabama, but there are two women in New York. This does not only examine the impact laws restricting abortion access is having on pregnant people, but the lack of resources in our complicated medical system. This book, of course, examines how race impacts maternal care, and I am personally upset I had not yet gotten around to Killing the Black Body by Dorothy Roberts (a must read in the field of Reproductive Justice, that the author regularly cites, as she should).
Significantly, this book was eye opening to me, a white woman in a blue state, on how having access to abortion is not the end of the conversation regarding safety in birth. Reproductive Justice is such a vast concept, covering more than just abortion, but our society does not discuss it, and I think it should.
Because of how difficult of a read this is, please look at trigger warnings. For a moment in the beginning I considered telling my friend who is pregnant with her first child about this book, but I quickly realized that is most likely a bad idea.
Thank you to Atria Books and NetGalley for an ARC in exchange for an honest review.
Unbearable is presented as a book on pregnancy and birth care, but I felt strongly while reading that it was a treatise on women's health care in general. Through the ongoing stories of five women (and sometimes their partners), Carmon shares stories about a health care system that is often indifferent at best and hostile at worst to the needs of American women. I started this book thinking it was going to be a study of the cruelty of abortion laws, but I found out the situation is much more complicated. Even when a woman is secure, partnered and wants the baby, the system can still let her down, to devastating results.
I had to put this book down several times as I was reading to sit with the stories until I could continue, but I kept going because I feel this is a very important read. No matter your place on the political spectrum, there is a long way to go before we are taking care of women they way they should be treated,
"There is no way to recognize embryos or fetuses as separate persons without subtracting women from the community of constitutional persons."
Many thanks to Atrium and NetGalley for allowing me the opportunity to read this ARC in exchange for my honest review.
As someone who has gone to great lengths to never get pregnant and have thought long and hard about the decision to not ever have children, Unbearable really cemented that choice for me. I already thought those with children were, for the most part, strong but after reading pregnant people's experiences have radicalized me even further. Being born and raised in Alabama, specifically in a city focused on in this book, I knew about the farce of chemical endangerment charges almost solely affecting pregnant and postpartum women, as well as the significantly higher chance of maternal death for Black women. Learning more about the history of obstetrics in Alabama, as well as the mistreatment, judgement, and limitation pregnant people of color and their partners face, even in different political climates, was a very much needed education and I'm glad I picked up Unbearable. Even though I'm someone who never plans on pregnancy, I still think Unbearable taught me many things every person in the United States should be aware of. If you're planning on becoming pregnant, can get pregnant, can get someone pregnant, or may utilize IVF, Unbearable is absolutely a must read, especially for those residing in the United States.
Thank you to Atria, One Signal Publishers, and the author for sending me an early copy!
I couldn't put down this book that combines the terrible history of gynecology in America with the stories of five women in modern America who, despite extremely different experiences, all suffered indignity and harm from the American healthcare system. This is not simply a story about reproductive justice but also about the criminalization of pregnancy and the lack of support women have both during and after pregnancy. Women in New York may have more right to abortion than women in Alabama, but they do not necessarily have access to care where they are listened to. Carmon makes a strong case that whether you want to be pregnant or not, the priority of our healthcare system is not the woman. Women are simply vessels and their safety and dignity is of less concern than the unborn.
I knew a decent amount about the racist and harmful history of gynecology but Carmon weaves that information in with the stories in a way that demonstrates how the racism and disrespect of women's bodies has been baked into our healthcare system from the start. She closes the book by saying, "We all deserve safer, more compassionate and connected care." Being honest about what we have instead is a good place to start.
Irin Carmon's “Unbearable” is a powerful look at the state of pregnancy care in America. Blending investigative journalism with personal reflection, Carmon explores how the country’s reproductive system has failed women. Through the experiences of five women navigating pregnancy in different settings, this book exposes how political decisions, medical neglect, and systemic inequities intersect to create a landscape of suffering and resilience.
Carmon's writing is empathetic and sharply analytical, pulling from history, policy, and lived experience to show how broken the system truly is. Her reporting is grounded and accessible, and her personal perspective adds emotional weight without overwhelming the facts. The result is both intimate and sweeping, connecting individual stories to larger questions of power, care, and justice.
“Unbearable” is a necessary, urgent book that refuses to look away from the realities of reproductive health in America. It’s essential reading for anyone who wants to understand not just the politics of pregnancy, but its effect on the people living through its consequences.
I still have about 2 hours left in the audio book but I had to come write down some feelings that I am having. I am a NICU nurse. I have seen the worst of the worst and been present for some horrible deliveries. I feel the author is being very very one sided with her portrayal of C-sections. C-sections have and will continue to save lives, baby's and mom's. The fact that she chose to put in her book the rare circumstance of a maternal death after C-section is actually sending a very harmful message that could potentially harm/kill mothers and babies. I am not impressed. Also, did she do her research regarding hospital policies? We do not allow the support person in the OR suite until the sterile surgical field is set up. If the mother is going under with general anesthesia (which is a possibility if an epidural was refused and now the situation is urgent) the support person will not be allowed back to the OR until the mother is intubated. This is a kindness. Would you want to see your loved one get intubated? Have you ever seen the procedure? Please do your research before you present a rare one-sided story.
There is one thing that anti-abortion activists fail to cultivate: knowledge of other women's experiences. The knowledge that women have a long history of operating birthing spaces as a community. Irin Carmon gifts the community experience back to women by following five individuals and having the reader walk their journeys with them. It would have been easy to state plainly at the front of the novel who these women are and what's going to happen to them. However, by forcing the reader to become attached to her main characters--Alison, Yashica, Christine, Hali, and Maggie--Carmon creates an experience in empathy, with brief detours to take stock of politics and history. There was a moment when I cried. I went into this book expecting a lecture and came out feeling like I had loved and lost friends.
This book is really an expose on women’s rights in America and how broken that system really is. This story illuminates the perils of five different women navigating pregnancy after the Supreme Court overruled Roe v. Wade. It shines a light on gender bias and poor policy making in the broken down system of maternal healthcare.
Written with empathy and great knowledge in reproductive rights, “Unbearable” is a real eye-opener. We live in a broken system and women, especially pregnant women, are the ones who suffer most. There was so much research put into writing this book and it is both illuminating and necessary to point it out.
Thank you, NetGalley and Atria Books for the advanced reader copy
I received a copy of this book in a Goodreads giveaway. The horrors that are the current state of women's health and reproduction are well spelled out in this book. This book isn't mainly about abortion, but about women who WANT to have children, and the horrors they face in trying to get care, the injuries they suffer, including dying, and about the horrors of some states who criminalize pregnancy for women, criminalize their lives and actions before they even know they are pregnant. I did find the chapter style in the book a bit disjointed, and had to backtrack to remember who different women were, but the horror of women's health in America today is well documented.
An important book. Carmon covers the current administration and the impact on lives in America since the Dobbs decision. I like how Carmon showcases both her excellent journalistic skills as well as her personal experience. And I think she writes one of the most powerful and clarifying conclusions that I’ve read of late. The topic of bodily autonomy and human rights alights all sorts of feelings, and I surely experienced both white-hot rage and deep sorrow while reading this book, but I think Carmon’s greatest talent is giving form and focus my sometimes nebulous (albeit well placed) righteous indignation.
"There is no way to recognize embryos or fetuses as separate persons without subtracting women from the community of constitutional persons."
“Early detection of pregnancy… can simply expand the parameters of when your body becomes state property.”
“Above all, she gave them the respect of assuming they knew what they needed to do with their own lives. If they wanted to have a baby, she would help them do that. If they didn’t, she would help them do that, too, on their own terms.”
read in less than 24 hours, such a good book. i have so many highlighted quotes. her chapter on how anti-abortion messages-arguments hurts literally everyone is so important.
Unbearable is a powerful and urgently important book—not just for anyone interested in reproductive justice, but for all readers invested in social equity and human dignity. Carmon writes with analytical rigor, emotional intelligence, and a keen sense of moral urgency. In a post–Roe America, pregnancy isn’t just a personal life event—it has become a political and ethical battlefield.
Carmon’s work serves as both an indictment of systemic failures and a compassionate plea for change. She makes it impossible to look away, reminding us that every policy shapes real lives, bodies, and futures.
***Thanks to NetGalley for this ARC in exchange for my honest review***
I liked, but did not love this book. Irin Carmon took on a huge task in exploring pregnancy in the US, and the magnitude of this job seemed to overwhelm the book. While all of the pregnancy stories were memorable and worthy, the connecting ties often got lost. There was simply too much to be covered and explored so that I wasn't sure why Carmon chose to dig deeper in some areas while leaving others alone. A narrower scope or focus could have made this more impactful.
Atria Books was kind enough to give me access to an eARC of this book (publication date set for October 28, 2025). This was a really enlightening read. It follows the stories of five women and the unique struggles they each faced during pregnancy while also underscoring the common ways in which our medical and legal systems have failed them all and so many more women in our nation. I highly recommend this book when it is released later this year!
Getting the perspective of the patients and care providers makes the issues real and raw. It is heart wrenching that there is no empathy or understanding for the patients or their providers. It is shocking that we are having this battle in this day and age. The author expresses an understanding of what is broken and how it can be fixed. Unfortunately, it feels like a cry in the dark. An author to follow and a good read.
Mark my words, I am going to teach this book someday. Brilliant from the first page. I couldn't put it down (just ask the two friends I literally ran into while reading/listening to the audiobook in HEB). Carmon is an immensely gifted reporter, weaving stories through rigorous scholarship with a deft hand. I'd recommend this to anyone who is a woman or loves one. It is the book (and the empathy for pregnant woman) that we all need in this moment.
Wow, this book was infuriating on so many levels. Some of these stories are so heartbreaking and these are just 5 stories of women in America. I wish there had been time for more stories. This book really made me think whether or not I want to bring a child into this world and if I do, to be so careful about the care I choose. This is just a reminder of how much inequity there is in the American healthcare system. I highly recommend reading/listening to this book for all Americans.